Garcines, Felipe D.

HRN: 03-86-50  Sex: Male

Patient Encounter


AMS Audit List

Audit Date
Antimicrobial
Start Date
End Date
Route
Dose
Frequency
Indication Documented
05/12/2026
CEFTAZIDIME 1GM (VIAL)
05/12/2026
05/19/2026
IV
1g
Q8
CAP MR
Checking Initial Appropriateness 
05/12/2026
AZITHROMYCIN 500MG TABLET (TAB)
05/12/2026
05/17/2026
PO
500mg
OD
CAP MR
Checking Initial Appropriateness 
05/12/2026
CEFTAZIDIME 1GM (VIAL)
05/12/2026
05/18/2026
IV
2g
Q8
CAP MR
Checking Initial Appropriateness 
05/12/2026
AMPICILLIN 1GM + SULBACTAM 500MG (VIAL)
05/12/2026
05/18/2026
IV
9g
Q8
CAPMR
Checking Initial Appropriateness 

AMS Audit Form


Start Date: End Date:

Indication:

              

Type of Infection:

                             

           

Compliance to guidelines:



Initial appropriateness:



 If inappropriate:

           

Final appropriateness:



 If inappropriate:

              

Overall appropriateness: